CATARACT- MYTHS & FACTS
Cataract is not a disease condition, but rather a degenerative process. Here the protein that constitutes the crystalline lens starts breaking down, due to various pre-disposing factors, rendering the clear lens cloudy. Thereby, disturbing the clarity of the vision.
RISK FACTORS
The factors that increase our risk of cataracts are:
- Aging.
- Smoking/ Drinking.
- Obesity.
- Family history of cataracts.
- Diabetes.
- Previous eye injury or inflammation (like Uveitis).
- Previous eye surgery (like Glaucoma).
- Prolonged use of corticosteroids (like in Rheumatoid Arthritis, Asthma).
- Environmental factors such as air pollution, industrial chemical wastes, pesticides, etc.
- Long-term exposure to UV rays from the sun.
- Radiation treatment for cancer or other diseases.
TYPES OF CATARACT
NUCLEAR CATARACT :
They affect the center of the lens. They are often associated with aging and may cause the lens to turn from white to yellow and eventually if left untreated, turn brown. In this distant objects appear blurred while clear at near. Over time even the near vision gets affected.
CORTICAL CATARACT:
They begin at the edges of the lens and slowly extend towards the center, forming spoke-like opacities. Patients may experience glare and halos around lights, particularly at night. They might also notice difficulty with depth perception and contrast sensitivity.
POSTERIOR SUB-CAPSULAR CATARACT:
This forms at the back of the lens and progresses more rapidly than other types. Patients often report difficulty in reading, seeing in bright light, and increased glares and halos around lights. This type is common in individuals who have diabetes or are on high doses of steroids.
ANTERIOR SUB-CAPSULAR CATARACT:
They form at the front of the lens as a white or opaque area, sometimes with a granular or plaque-like appearance. This can be caused by trauma, inflammation (like uveitis), certain medications (especially cortico-steroids), or radiation. The symptoms associated with it are blurred vision for distant &near and glare.
CONGENITAL CATARACT:
In this category, the patient is born with a cataract. They are either passed down from parents or may be associated with an infection or trauma during gestation or parturition They may also be due to medical conditions such as myotonic dystrophy, galactosemia, neurofibromatosis type 2, or rubella. Symptoms vary but can be seen as white or grey opacity peeping in the papillary area, misaligned eyes(strabismus), and poor visual development.
TRAUMATIC CATARACT:
They result from an injury to the eye, which may cause immediate or delayed clouding of the lens. Symptoms include blurred vision, double vision, or profound vision loss depending on the severity of the injury.
SECONDARY CATARACTS:
Secondary cataracts, or Posterior Capsule Opacification (PCO), occur after cataract surgery. Over time, the membrane that holds the artificial lens in place becomes cloudy, leading to blurred vision and glare. Treatment for secondary cataracts typically involves a YAG Laser Capsulotomy (YAG Cap). During this non-invasive procedure, a laser is used to create a small opening in the clouded capsule, allowing light to pass through and thereby restoring clear vision.
SYMPTOMS OF CATARACT
The symptoms may be as:
- Blurred vision for distance and near.
- Night vision problem.
- Sensitivity to light and glare.
- Need for brighter light for reading and other fine near work.
- Frequent change in glasses or contact lens prescription.
- Fading or yellowing of colors.
- Double vision.
- Difficulty in differentiating colors.
- Decreased contrast sensitivity.
PREVENTION:
No studies have proved how to prevent or slow down the growth of cataracts. But eye-care professionals suggest a few strategies that may be helpful, such as
- Regular eye examination.
- Refrain from smoking and alcohol usage.
- Manage other prevailing medical conditions such as hypertension, Diabetes, Asthma, Arthritis, etc.
- Choose a healthy diet that includes plenty of fruits and vegetables.
- Studies have shown, that antioxidants in pill form can prevent cataracts.
- Wear polarized sunglasses when working outdoors for a long period, to prevent the adverse effect of UV rays as cataract formation.
MANAGEMENT AND TREATMENT
Cataract surgery is the only way out to remove cataractous lenses and restore vision. During the cataract surgery, the Ophthalmologist (eye surgeon) removes the clouded lens and implants an artificial one -Intra-ocular Lens (IOL). Cataract surgery is one of the safest and most commonly performed surgeries with almost no serious complications. But certain eye conditions or underlying medical conditions such as Hypertension, Diabetes, Asthma, Glaucoma, Uveitis, etc may raise the risk of complications if not under control before the onset of surgery. Moreover, gone are the days when incisions made during the surgery were broad and stitches were applied thereafter. With the advent of new technologies things have become better- SIMPLY STICHLESS SURGERY WITH MICRO-INCISION.
Why Patching the Eye and Wearing Black Goggles Post-Cataract Surgery is Necessary.
Cataract surgery is one of the most common and successful procedures performed today, with millions of patients regaining clear vision each day. Despite the effectiveness of modern surgical techniques, post-operative care plays a crucial role in ensuring a smooth recovery and preventing complications. Two essential aspects of this care are the use of an eye patch immediately after surgery and wearing black goggles in the following days.
Patching the Eye:
Protecting the Surgical Site
Immediate Protection: After cataract surgery, the eye is particularly vulnerable as it begins to heal. The surgical incision, though small, needs time to seal and heal. Patching the eye immediately after the procedure serves as a protective barrier, preventing external contaminants such as dust, bacteria, or other foreign particles from entering the eye and causing infection or irritation.
Preventing Accidental Contact:
The eye patch also helps prevent accidental rubbing or touching of the eye. Post-operative patients may instinctively rub their eyes due to mild discomfort or itching, which can disturb the healing process. By covering the eye, the patch reduces the risk of accidentally displacing the newly implanted intraocular lens or causing additional trauma to the surgical site.
Minimizing Light Sensitivity:
In the hours following surgery, the eye is typically sensitive to light. The patch helps block out excessive light, reducing discomfort and giving the eye time to adjust to the changes following the procedure.
Wearing Black Goggles: Continued Protection and Comfort
Shielding from Bright Light:
After the initial period of patching, patients are advised to wear black goggles for several days. These goggles are designed to shield the eyes from bright light, which can be particularly harsh on the healing eye. Cataract surgery patients often experience increased light sensitivity, and dark lenses help alleviate this by reducing glare and filtering out intense light.
Preventing Dust and Debris:
Black goggles serve as a physical barrier, similar to the eye patch, but allow the patient to maintain vision while protecting the eye. They prevent dust, pollen, and other environmental particles from coming into contact with the eye, reducing the risk of post operative complications such as infections or inflammation.
Supporting Proper Healing:
The lenses of the black goggles are often UV-protective, which is crucial for patients who have just undergone cataract surgery. Exposure to UV light can be harmful to the healing eye, and wearing these goggles helps safeguard against potential damage from sunlight, promoting a healthier recovery process. Reducing Eye Strain: Post-surgery, the eye may be prone to strain, especially when exposed to bright screens, lights, or outdoor environments. Black goggles help reduce eye strain by dimming the intensity of visual stimuli, making it easier for the patient to go about their daily activities without discomfort.
Returning to Work: Factors Influencing Recovery Time
Timing of Return to Work:
The decision on when to return to work after cataract surgery depends on various factors, including the nature of the patient’s job, the type of lens implanted, and the individual’s overall health. Generally, patients can return to office work within a week if their job does not involve strenuous activity or exposure to dust and debris and with the Consultants prior consent.
Type of Lens and Recovery:
The type of intraocular lens (IOL) implanted during surgery can influence recovery time. Monofocal lenses, which provide clear vision at a single distance, may require patients to adjust their activities depending on whether they need glasses for near or distant vision. Multifocal lenses, designed to correct vision at multiple distances, might allow for a quicker return to normal activities, as they reduce dependence on glasses.
Post-Operative Care:
Adherence to post-operative care, including the on-time use of prescribed eye drops, avoiding heavy lifting, avoiding head-bath, and following the surgeon’s advice on wearing protective eyewear, is vital for a smooth recovery. Patients who diligently follow these guidelines are more likely to experience a quicker and more comfortable return to their daily routines.
Patching the eye and wearing black goggles after cataract surgery are simple yet crucial steps in the post-operative care process. These practices protect the healing eye from potential harm, minimize discomfort, and support a faster recovery. By following these guidelines, patients can help ensure that their vision is restored effectively, allowing them to enjoy the full benefits of their cataract surgery with minimal complications.